HEALTH TRAIN EXPRESS
Follow or subscribe to Health Train Express as well as Digital Health Space for all the updates for health policy, reform, public health issues. Health Train Express is published several times a week.Subscribe and receive an email alert each time it is published. Health Train Express has been published since 2006.

Tuesday, January 31, 2012

Disclaimer ! Health Train Express nor it's author endorses this method of self CPR. The user must judge for themself whether to do this or not... The user accepts full responsibility, regardless of the outcomes. Note: Medicare does not allow for reimbursement...do not bill Medicare.

Let's say it's 6.15pm and you're going home (alone of course),after an unusually hard day on the job. You're really tired, upset and frustrated. Suddenly you start experiencing severe pain in your chest that starts to drag out into your arm and up into your jaw. You are only about five miles from the hospital nearest your home. Unfortunately you don't know if you'll be able to make it that far. You have been trained in CPR, but the guy that taught the course did not tell you how to perform it on yourself..!!KNOW HOW TO SURVIVE A HEART ATTACK WHEN ALONE..Since many people are alone when they suffer a heart attack, without help, the person whose heart is beating improperly and who begins to feel faint, has only about 10 seconds left before losing consciousness.However, these victims can help themselves by coughing repeatedly and very vigorously.A deep breath should be taken before each cough, and the cough must be deep and prolonged, as when producing sputum from deep inside the chest.A breath and a cough must be repeated about every two seconds without let-up until help arrives, or until the heart is felt to be beating normally again.Deep breaths get oxygen into the lungs and coughing movements squeeze the heart and keep the blood circulating.The squeezing pressure on the heart also helps it regain normal rhythm. In this way, heart attack victims can get to a hospital.Rather than sharing jokes please.. contribute by Sharing this which can save a person's life!!!!

I happened to sit in on the Google + Hangout on the Live Stream. There were only five active participants allowed. The questions were drawn from a pool of pre-submitted YouTube videos sent to the Whitehouse. Initially the guidelines were the most popular questions or watched videos watched by YouTube Videos would be addressed. However at the last minute the guidelines were changed to the White House Selected questions.

The questions were from the usual list of candidate debate issues. It was a well manicured session from ‘the groupies’ with all smileys and nods,and thank you Mr. President.One of the questioners grilled Mr. Obama about the lack of employment opportunities for engineers, one sector of the economy that is supposedly was recovering quickly Mr. Obama went so far as to ask one of the participant spouse’s to send his professional resume to him to assist his job search in engineering.

Some topics avoided: SOPA, OWS, Education Costs

There was no discussion about healthcare and/or Obama care.

Mr. Obama and his managers obviously think healthcare is off the radar.

Even if healthcare was on the radar the committee of inquisition would not have known the right questions.

1. Will there be an ACO in my neighborhood? (Will I even have a doctor?)

5.Can HIPAA be waived voluntarily by patient and provider for the use of social media to improve efficiency and drive down the number of office visits and expense?

I summed it up like this when I was asked how it went. My response, “I decided at half time to go out to get soda, popcorn, and a hot dog, then decided not to go back. The second half was like the first. no last minute touch down runs….interceptions, or fumbles. At least the hot dogs were ballpark fresh !

Most of these pilot programs are modeled after other ‘exceptional program’ already in progress. The selection criteria is the cost of Medicare services in specific regions of the country and an attempt to duplicate practices in each of these regions. Keep in mind this is a report from the CBO (Congressional budget office) which is only one measure of success or failure of a project. Nothing is said about quality of outcomes, return on investment of new paradigms of bundled payment, readmission to hospitals, morbidity or mortality reports. It is a report from an agency totally separate from HHS or CMS.

Successful innovations are produced by entrepreneurs, challenging conventional thinking — not by bureaucrats trying to implement conventional thinking.

On the supply side, we have the islands of excellence (Mayo, Intermountain Healthcare, Cleveland Clinic, etc.). On the demand side, we have a whole slew of experiments with pay-for-performance and other pilot programs designed to see whether demand-side reforms can provoke supply-side behavioral improvements. And never the twain shall meet

Can you think of any other market where the buyers of a product are trying to tell the sellers how to efficiently produce it?

Well put John Goodman. You have articulated well my meager general common sense approach and decades long observations of clinical practice.

Sunday, January 29, 2012

Health 2.0 India Conference #health2india
This meeting should be extraordinary given that so much software development originates in Asia.
I invite the attendees to tweet using the hashtag given by Matt Holt #health2india.
I am providing information about Google Plus Hangouts. The invitation will be in my Google + stream +Gary Levin Instructions for joining and using Google + and hangouts are readily available via Google + and searching. I will also send invites to anyone who wants to receive a direct link, Just send me your email.
Here’s the link to look at G+ and see if you want to prepare early.
Join Google +
The Hangout will open in 6 hours (Sunday) (6 PM PST) Monday 7AM (Delhi) It will be operational from 7AM to 7PM Delhi time.
Other participants can open their own hangout, however hangouts cannot be initiated on smartphones or tablets unless you are on Wi-Fi.

No, the # sign is not an unprintable explicative. Any tweep recognizes # as the hashtag for identifying interest group. The one we use most often in health social media is #hcsm (health care social media). If you search using the # it will identify and stream that interest. If you are sending a tweet using that # it will appear in those tweeps who are searching for #hcsm. It is a bit like the Search of twitter like Google Search.

The Foxe group provides the definitive wiki for #hcsm. T. Lee has developed a glossary of hashtags for specialties, conferences,diseases and more. The Fox Group had the prescience to develop a division strictly devoted to social media in all of it’s iterations.

We are still working out some ‘bugs’ in the new template(s) Our blogroll and other items of interest do not appear in the templates other than in the ‘classic’ view. Our webmaster (me) is working feverishly on this with Larry Paige’s staff.

Despite Google hibernating Google Health there is still a strong interest in the Health Space. Health Train is encouraging this interest. Google has the power, market influence and capital to do some great innovative things in supporting healthcare, such as chrome books and the android operating system which is ‘open source’. Many great innovations (like health and medical science advances) are developed by young developers, many of whom do not work directly for Google. It is amazing how much of it is from high school students who are not employed by anyone and who either donate their ideas or are paid on a contract basis.

I encourage you all to search Google for their product development division to open a dialogue with your ideas.

For now, Health Train Express is leaving the station, bound for our next stop.

Saturday, January 28, 2012

Anyone who has been observing social media can see that Social Media adoption in Medicine will make electronic medical record adoption seem turtle slow, , and SM has not required governmental funding or incentives. No you won’t be penalized financially for not adopting it, and it’s meaningful use becomes apparent without a cookie cutter list developed by some unknown bureaucrats who have never seen, treated or healed a patient.

Here are only some of the things doctors and their staff will be using it for.

1 Human Resources: Interviewing job candidates with two or three of your staff in the hangout. Prospective employees will be able to share documents right in the hangout. Your staff can “grill” the candidates and size them up. This will save enormous time for both sides in the process of hiring. Unemployed people do not have much disposable cash for driving to interviews.

2.Purchasing: A hangout with your supplier or medical device representative to ask questions and receive direct video feedback on items you wish to purchase.

3.Pharmacy reps no longer have to visit you directly to talk about their new wonder drugs. However food cannot be served in the hangout. You can order Domino’s Pizza online.

5.There are many other potential uses for G+ Hangouts, I am sure your staff and patients will think of many more.

The new dynamic view is in full swing, and I hope you are enjoying it. You may have noticed you have a choice of views from the tabs on the top banner. I like Flip board due to it’s ability to find older posts without scrolling.

Our next step will be integrating Google + Hangouts directly from the blog where you will be able to Join Me in my hangouts to offer criticism, and knowledge. You will be able to share documents, you tube videos, and windows running in the background, such as spreadsheets, slide programs, and PowerPoint decks. Isn't technology great?!

Thursday, January 26, 2012

About a year ago I had thoughts about a major change in the Health Train layout. Well, I thought about it, and thought about it, and thought about it some more. Much happened in health reform, health IT and also in social media during 2011 As it turned out I am happy I waited..

Six months ago 64% of physicians were using social media. In January 2012 over 95% of MDs were using social media in some form in their medical practice routine.

Health Train Express was one of the first health related blogs in the social media stream; we have been a loyal user of the blogger platform all these years (almost ten years)

Under-rated blogger has given us consistent performance all along. It is much simpler to use than WordPress, Drupal and other blog platforms.

It suffers from the illusion that since it is not a standard .com domain it receives less respect among bloggers. Platforms however do not make the content.

The announcement Health Train Express will transform later today or tomorrow onto the new Blogger dynamic platform. This will create an exciting visual display of posts which will easily allow access of older posts and archived posts without a more……tab at the bottom of each page

As you may know Blogger has been owned by Google for some time. You also know that Google turned of it’s Google Health Platform on December 3, 2012.

Look for the

The change will create a tight integration with most of Google’s services and applications. Health Train Express will also be available as a Google Page.

It will increase it’s readership and visibility using all of Google’s power with integration into Google plus with each post and also enable real-time access to Google Hangout’s for those who wish to do so. There will be a Google + widget to enter our Google + stream and any active hangouts. If you own a Google plus ID it will allow you to send an invitation to Health Train Express’ hangouts by way of a ‘JOIN’ button that pops up in our G+ stream, our email and a pop-up Google IM chat box.

It may be several days until all is working smoothly.

Health Train Express is now aggregated by Health Works Collective, Friendfeed, Social Media Today, Summify,

Monday, January 23, 2012

Have the feds stepped over the line? It would appear so according to a report from Forbes Magazine. Peter Ferrara reports the Social Security Institute (not to be confused with the SSA) and the American Civil Rites Union (ACRU) filed an amicus curiae brief at the Supreme Court.arguing that Obama Care's expansion and transformation of the Medicaid program violates the Tenth Amendment under the Court’s Coercion Doctrine. In overstepping the bounds between acceptable pressure and unacceptable compulsion, Obama Care transgresses state sovereignty and violates the constitutional framework of federalism.

Without going into great detail the Medicaid requires an all or none approach to receiving federal matching funds. A refusal to accept the mandate could lead to a loss of all Medi-caid matching funds.

Medicaid is an all-or-nothing, take-it-or-leave-it proposition for the states; they must comply with all federal terms and conditions as a requirement of participating in any part of the program. Consequently, Medicaid has become a contract of adhesion, which gives the appearance of mutual consent between both parties but, in fact, allows one party to impose terms on the other party who has no real ability to negotiate terms due to its extremely unequal bargaining position.

To change the terms so drastically to the detriment of the states of what might originally have been a truly “voluntary” program—now, after the states have become financially dependent on (literally addicted to) the federal aid it offers—saps all semblance of “voluntariness” from Medicaid.

The brief calls this ‘unacceptable coercion’ and violates the terms of the tenth amendment of the U.S. Constitution.

Sunday, January 22, 2012

This is the year that will make or break the health care law States were supposed to be partners in carrying out the biggest safety net expansion since Medicare and Medicaid, and the White House claims they're making steady progress.

However, Three out of four uninsured Americans live in states that have yet to figure out how to deliver on its promise of affordable medical care.

It reveals a patchwork nation. If it continues, it will mean disparities and delays from state to state in carrying out an immense expansion of health insurance scheduled in the law for 2014. That could happen even if the Supreme Court upholds Obama's law, called the Patient Protection and Affordable Care Act.

About half the states are suing to overturn the law. The Obama administration says uninsured patients have nothing to fear. Steve Larsen, director of the Center for Consumer Information and Insurance Oversight at the federal Department of Health and Human Services.says “"The fact of states moving at different rates does not create disparities for a particular state's uninsured population,"

That's because the law says that if a state isn't ready, the federal government will step in. Larsen insists the government will be ready,

Easier said than done. It’s complicated. Some of the necessary steps follow.

Someone has to set up health insurance exchanges, new one-stop supermarkets with online and landline capabilities for those who buy coverage individually. Many states have refused to do this.

A secure infrastructure must be created to verify income, legal residency and other personal information, and smooth enrollment in private insurance plans or Medicaid.(this sounds like a lot of duplication and paperwork. It also raises the specter of the IRS and State taxation agencies providing data to the HHS or State Health Departments. (or send your W2s to the State HIE, and then they will cross check with the IRS….That sounds very ominous but should be no surprise seeing how Congress passed NDAA and almost did the same with SOPA. note: Secure infrastructure? Does this sound like health care and/or health insurance?

Over half the states are suing the federal government, which will be heard by the Supreme Court this spring. Not much will take place at the state level until there is a decision regarding constitutional issues. It is pitiful that the states had to resort to quoting the constitution when there are so many other good reasons for not enacting this financially irresponsible mandate..

The startup, re-organization and continuing maintenance of these new bureaucracies will undoubtedly devour any ‘savings” predicted from ACOs, revisions of payment methodology based upon better outcomes and improved quality of care.

The final coup d’ etat is the state of the economy where job production is poor. These added responsibilities will not foster new businesses, nor jobs.

So be insured, and remain unemployed. Does it have to be one or the other?

How about some sensible moderation and common sense? Is anyone listening in Washington?

Wednesday, January 18, 2012

Mobile Technology Is Transforming The Health Industry, But To What Extent?

Dave Chase

Technology is in the process of bringing change to every piece of the health industry — wellness, fitness, healthcare, medicine — you name it. And as it always seems with introduction of new technologies, it’s awe-inspiring how quickly they can transform entire industries yet, at the same time, make us realize just how far we have to go (or how far behind we really are). The health industry has been touched (and defined) by cutting-edge technology for years, yet its relics, legacy infrastructure, paper-pushing, and archaic procedures are as obvious today as ever before.

Some mobile apps interface patient and physician, Mobile devices will also change the way that we communicate with our doctors, as physicians may help describe possible treatments or procedures to patients on an iPad using multimedia, visual cues, genomic/anatomical maps, etc., prescribe post-treatment apps to our smartphones so that treatment doesn’t end once you walk out the door of the hospital, or become a conduit for modern communication platforms, a la Skype, that will facilitate remote checkups, treatments, diagnostics, through the phone, or over video. Got a strange looking rash? Take a picture, or scan it on this app. Telemedicine is there in a pinch!

All this has developed almost spontaneously with the development of competing hardware devices and software which is open source. and at affordable prices given the size of the patient market. The primary ingredient is innovation, entrepreneurial spirit, and with little governmental funding and/or intrusion.

Contrast this with the stuttering acceptance of EMRs and HIEs with government mandates, artificial support with incentive subsidies to support the HIT vendor market. The real beneficiary for CMS’ incentive program are the HIT vendors, not patients, not doctors nor insurers. The data collectors will benefit from the system which will be mined for the benefit of cost containment and perhaps better outcomes.

Tuesday, January 17, 2012

No this post is not about pubescent hormonal hyper sexuality nor the story about the sex life of fan boys or fan girls, G+strings,, or tantalizing twitter tweepes. It is a story about Fred and Regina Holladay and their experience (bad) when Fred was diagnosed with advanced Renal Cancer.

Over the past ten years both college and medical school tuitions have increased in some cases four times. This has effected college graduates and physicians. Tuition at the state run UC system in 2001-2002 was $ 3429 and has risen to $13,200 per year. This places an extraordinary debt burden on students at a time when they have little income.

In California which has faced the perfect storm of decreasing revenues in the face of economic distress Chris Occasion, President of the FixUCR movement at the University of California presented a manifesto

Their manifesto is the UC Student Investment Proposal, which calls for eliminating the upfront costs of college and having working graduates pay 5 percent of their salary back to the system for 20 years.

The idea was conceived by students, and although designed for the UC system could very well be adapted to other states and private universities.

The investment proposal concept has captured the attention of the Board of Regents of the UC system and was a concept previously studied and discussed by Robert Reich former Secretary of Labor under the Clinton Administration. He presented a similar idea in 2008 for California’s mounting fiscal stresses. Economists at the time termed the financial plan feasible however it was deemed politically undoable. This would not be the same for privately funded schools of higher education.

A similar perfect storm has developed in health care and medical education which is even more expensive and extended eight years up to twelve years. And while college graduates may complete undergraduate education with a $100,000 debt load, some physicians will exit from medical student and

training with up to $ 250,000 debt.

Health reform promises two events, more insured patients, decreased reimbursements and a shortage of primary care physicians (family physicians).This will decrease ability for physician graduates to repay education loans. Adjusting payment rates as a percentage of income adjusts for future changes in income.

Many well qualified students rule out medicine as a career because of it’ prospect of prolonged poverty and what often appears to be insurmountable debt. Some highly qualified students will change career goals

Friday, January 13, 2012

USA TODAY reports that 22 % of healthcare spending is from less than 1% of patients.(2009).

That's about $90,000 per person, according to the Agency for Healthcare Research and Quality. U.S. residents spent $1.26 trillion that year on health care.

Five percent accounted for 50% of health care costs, about $36,000 each, the report said.

Why is this number so important? According to AHRQ the report showed how a tiny segment of the population can drive health care spending and that efforts to control cost should focus on this segment to improve efficiency using new technology, outcome studies,

About one in five health care consumers remained in the top 1% of spenders for at least two consecutive years, the report showed. They tended to be white, non-Hispanic women in poor health; the elderly; and users of publicly funded health care.

•Sixty percent were women

•Forty percent were 65 or older.

•Only 3% were ages 18 to 29.

•Eighty percent were white.

•Only 2% were Asian.

The found that Hispanics, 16% of the population in 2009, spent less on health care. Twenty-five percent of Hispanics were in the bottom half of health care spenders, the report showed, while only 7% of Hispanics were in the top 10% of spenders.

Next, Cohen plans to look at whether cost-cutting measures make a difference. Beginning in October 2012, the government has told hospitals with Medicare patients that it will no longer pay for patients who are readmitted to hospitals for the same condition soon after being released. Cohen said he'll look at whether that will change the spending averages for people in the top health care cost brackets.

Another way of stating this is, “unmarried women” (uninsured) (or Medicaid) and old people on Medicare

RFID for security is available with small tags on laptop cases, smartphones, iPads and the like “Tags” are available for pets and even children to keep them from wandering off. It could even be used for ‘colleagues’ and peers to keep from losing each other even significant others or spouses. (in an extreme case).The potential for use in hospitals is great to locate patients who may be roaming to special testing. Physicians hate going to an empty room when they expect to see the patient.

Digital healthcare was no stranger at the CES. From Panasonic to Allscripts medical applications are being mainstreamed even in the consumer retail market place. COSTCO offers the Allscripts My Way EMR which can be purchased at any Costco warehouse.

In addition to mobile apps and advances in display technology the merger of automobile connectivity within the vehicle and also externally for safety features are being emphasized as selling points for vehicles

Ford, Microsoft, Healthrageous and BlueMetal Architects announced an alliance to research technology to help people monitor and maintain health and wellness while on the move during the “Doctor in Your Car” keynote address at the Digital Health Summit at the 2012 International Consumer Electronics Show (CES).

An interesting statistic (Pew)

More people now visit online health sites than go to the doctor’s office, making health and wellness the most popular activity on the Web after email and general searches.

Social media was also a large component of the CES. Reporters, presenters, and observers were all well connected via email, im, twitter, FB and Google +. Multi-tasking was a necessity on the floor and in the booths. The infrastructure to support this seemed to be better than in most previous CES’ The learning curve from previous event was obvious and the ‘show’ ran smoothly There appeared to be little difficulty with broadband access nor bandwidth. Convention centers seem to have caught up with the never ending growth of demand for wider ‘pipes’.. I watched much of #CES from the comfort of my desk , at C-net, Ustream.tv and Techcrunch,and Twit.tv .

Senior citizens are getting much attention from politicians and health care professionals. Deservedly so since they are the unfortunate who are involuntarily ‘consuming’ health care. It’s the nature of aging and human life.

No one wants to be ill or infirm. The term “consumers of health care’ implies that healthcare is produced, or that health itself is produced. Perhaps that is what preventive medicine, healthy diets, exercise, stressful living and a good quality of lifestyle is all about.

The list of links at the start of the article is for mature adults and their caregivers. (credits to Bertalan Mesko MD and Webcina. I recommend giving it to you patients.

Saturday, January 7, 2012

Val Jones MD, perhaps the empress of health social media, and Better Health has announced her discontinuation of posting blogs on Better Health LLC. She however indicated the continuation of the brand as a platform for Grand Rounds and for her use of it as her personal consulting platform.

Dr Jones, along with others, has been a visionary and developed considerable credibility with early backing from Revolution Health and Steve Case’s interest in health reform. Her success required considerable investment of time, resources and the generous support of many silent investors, physicians, nurses and medical journalists. She innovated aggregation of gifted medical writers into a visible public platform for medical news.

There were and are a central core of respected experts contributing to Better Health and these contributors will continue to create content in their own spaces.

Thank you to Val Jones M.D. for her effort and success in opening a new vista in communication for patients and providers. I will miss her cartoons.

Better Health was and is more than a blog. It matured into a digital form of a medical journal, branding itself as an online media company. It has served it’s purpose and will continue in the digital health space, not to be left behind.

Many new entities are evolving, such as Social Media Today, Health Works Collective, and many others as the niche matures.these follow the early leadership of iHealthBeat, and California Healthline.

Social media in medicine is evolving quickly and in order to continue our success we must all evolve as it morphs into new delivery methods.

Researchers have started recognizing the importance of sunlight for a healthy lifestyle, recent studies reveal that sunlight renders many health benefits. Apart from Sunlight maintaining temperature and humidity, sunlight plays a significant role in nourishing and energizing the human body. It is also vital in order to get the full nutritional value from food that you consume and it has been proven that getting sufficient sunlight aids in preventing chronic ailments such as seasonal affective disorder (SAD), osteoporosis, mental depression, type 2 diabetes, and cancers affecting the bladder, breasts, cervix, colon, ovaries, prostrate, and the stomach. To put it more succinctly, sunlight serves as the perfect medicinal pill in promoting a healthy lifestyle.

One of the prime benefits of sunlight is that it supplies the body with Vitamin D, which not only promotes the absorption of calcium in the gut but also transfers calcium across the cell membranes. This in turn provides strength to the bones as well as contributes for a healthy nervous system by increasing the production of endorphins in the brain. Usually, deposits of cholesterol-like substances known as ergosterol can be found beneath the skin, which gets converted into Vitamin D hormones when the sunlight penetrates the skin.

Vitamin D also helps to lower the level of cholesterol in blood, and sunlight can even prevent the growth of cancerous tumors. Studies show that exposing your face to sunlight for 10 minutes every day can provide your body with the Vitamin D that is required for the day. A lack of Vitamin D is associated with a host of autoimmune ailments such as Crohn’s disease, multiple sclerosis, rheumatoid arthritis, and thyroditis.

Another significant benefit of sunlight is that it helps in the prevention of infections resulting from bacteria, molds, and viruses. The health benefits of sunlight include the enhancement of the immune system by increasing the count of white blood cells as well as gamma globulin, which is beneficial in warding off viruses and germs and it enhances the capacity of red blood cells in carrying oxygen.

According to certain studies, getting adequate sunlight serves as the perfect exercise for the heart, as it enables the body to lower the resting pulse rate and decreasing hypertension, thereby making the heart healthier. Sunlight also provides resistance power to the skin, by avoiding skin diseases such as psoriasis, eczema, and acne problems. Further, getting sunlight is also correlated with the stimulation of the pineal gland, which produces such vital chemicals as tryptamines.

Other health benefits derived through the exposure of sunlight are:

Strengthening of cardiovascular system

Normalizing blood pressure as well as blood sugar

Increased metabolism

Aiding in weight loss

Ensuring proper functioning of kidneys by eliminating wastes

Enhanced liver function

Improved digestion

Above all, sunshine has that magical power to alter your moods and cheer you up, thereby preventing anxiety and depression

Despite its advantages, excess exposure to sunlight may be sometimes destructive, as it can lead to ailments such as eye damage, melanomas, and skin cancer. Likewise, over exposure to sunlight may sometimes result in a change in the color as well as the size of the skin, appearance of irregular spots on the face, and itchiness or tenderness to the skin.

In other words, benefits derived from the sunlight depend upon its usage. Methods such as sunbathing and sun tanning are considered effective for getting adequate sunshine, but make sure that you are using a quality after-sun lotion in order to moisturize your skin after sun tanning. Likewise, put on such clothes that cover your arms as well as legs after sunbathing, which in turn safeguard you from further exposure. However the most important thing to remember that an excess of anything, including sunlight, can be damaging to your health.

Mobile apps are the big items this year, not only in health care, but in a multiplicity of other niches.

When a powerful blizzard ripped through North Dakota last winter, hundreds of drivers were stranded as white-out conditions shuttered interstates statewide.Even in large metropolitan areas sudden and large snow storms can paralyze drivers with other cars close by. The recent Chicago Lake Shore drive emphasizes the fact that this does not occur in only North Dakota.

That convinced two local software developers to create the Winter Survival Kit app.

North Dakota State University's Bob Bertsch and Jake Joraanstad came up with the free program for iPhones and Android smartphones to help motorists prepare for winter driving and when things go badly.

One app available through the iTunes app store is a crossover, linking mobile apps for driving and prevention of possible frostbite and even death if isolated by blizzard conditions and being stranded in your car.

The application “Winter Survival Kit” can be downloaded for FREE at the iTunes app store. It will function on the iPhone, iPad and also on Android Phones

This app will help you find your current location, call 911, notify your friends and family, calculate how long you can run your engine to keep warm and stay safe from carbon monoxide poisoning.

Version 1.3 update December 2011, and all reviews give it a 4-5 star rating.

The application provides instructions for preparations for cold weather survival and what to do if stuck in your car.

It also functions as an emergency 911 alert and will supply geolocation information to emergency dispatchers.

Other information it can calculate is time until your fuel runs out, and to remind you to check your exhaust every 30 minutes to prevent asphyxiation from carbon monoxide.

HealthTrain Express assesses this device as a mandatory one for anyone who drives in a cold weather climate. It’s usefulness may be restricted in areas that do not yet have cell phone availability. If you are on one of the U.S.National Defense Highways (Interstate Highway System) it’s a fairly safe bet you will have cell coverage.

The only thing it does not seem to do is make hot coffee….perhaps in version 2.0

Remember also that if cell phone strength is week text messaging may still function….use Twitter, SMS or IM.

Friday, January 6, 2012

Major revisions will be made to California’s health safety net, with reorganization and downsizing big government. No doubt this will be unpopular in some circles. This is further complicated by federal mandates for health insurance exchange formation and proposals to use Medi-Cal as a vehicle for uninsured, uninsurable, and poor.

Warning: This post may not be appropriate for readers under the age of six.

The article is not intended to be discriminatory in terms of sexual preferences, race, creed, color or political preferences.

I am expanding upon an article read in the WSJ Health Blog today.

A recent study reported in the WSJ Health blog discusses the overall slight decline in rates of cancer with an uptick in certain types of cancer.

Among the small increases are the incidence of oral cancers (HPV papilloma of the posterior pharynx, malignant melanoma, thyroid cancer, Although the decline in smoking should decrease this incidence it appears that ‘oral sex’ increases the rate for practitioners of this art of karma sutra.

I have given up cigarettes, alcohol, marijuana, meth,cocaine but I will not have oral sex withdrawn (pun intended) from my repertoire of pleasurable activity.

Several important features of the study were missing, male vs. female rates, unprotected vs. protected sex and whether the study was separated into homosexual encounters or heterosexual encounters.

The CDC and Public Health Service have been allotted ten million dollars for this anti-motivational poster, seen on the left below which is somewhat akin to the anti-smoking images seen below as well

P.S Smoking is banned on the Health Train Express, Oral fellatio? That depends….

The entire post is offered (tongue in cheek). Oh there I go again with my oral fixations this morning I am having oatmeal with bananas (cut up for those of you with dirty minds…). Hope you enjoy your coffee !

I have been a proponent of social media and it’s use to improve healthcare and improving accessibility for patients to clinicians and hospital resources, there are certain caveats and precaution are advised when attempting ‘self diagnosis’

In the past ten years innumerable web sites have become available for patients.. Remembered that these sites were never meant to be used in an isolated fashion for self diagnosis. They are meant to be educational and as a supplement to professional office or clinic visits.

Entering or searching for symptoms both physical or emotional into a web site will list many answers, some irrelevant. These sites can be accessed either before a visit or after a visit to assist you in discussing your condition with your health provider.

Today’s both physicians and patients are faced with decreased face-time during the visit. Web sites are a positive influence for both physician and patient when used properly.

They provide the patient an opportunity to ask appropriate questions for the health provider on initial visits, and for follow up education especially if the provider educates his patient as to what sites are credible sources as a supplement to the office visit. Patients should discuss their sources with their doctor.

Social media also provides relevant and usually accurate information about health information technology advances, not only in EMRs, HIEs but the explosion of mobile apps for their use in non clinical settings, home monitoring and accessing insurance information, geolocation services for emergencies, hospital and offiice wait times, and drug information.

Tuesday, January 3, 2012

Take a look at the Info graphic below…. This is taking place in a single minute — every minute — of most everyday within the digital world….

Still think it’s a passing fad?

Still think you do not need to establish some form of digital presence on the healthcare social media stage?

—Think again —

http://goo.gl/Bwz1d By: Shanghai Web Designers

Howard J Luks M.D. points out the reasons why physicians should participate in the landscape of social media in his recent post via Summify.

Dr Luks message and articulation of the message is so well put that I repeat it here, and give him full credit for this information. It bears repeating in my blog(s).

I happen to agree with him. Issues surrounding health care and health reform have become much more public, open and transparent. Physicians must use the medium which is presently gaining momentum to replace printed and rapidly becoming obsolete magazines, newspapers and other forms of advertisement.

Let’s face it most studies and experience show the decline of ‘established newspapers, and journals. This is even more apparent in the under age 50 demographic.

Dr. Luks points out:

50% of the world’s population is under 30.

They do not communicate via e-mail or telephone.

Generation Y and generation Z consider e-mail passé.

The fastest growing segment on Facebook is women over 55 years of age.

50% of the mobile Internet traffic in most countries is for Facebook. One on five patients flock to Facebook for healthcare information. Imagine what this means for a bad patient experience? The world has gone digital —social media is here to stay. 1 billion people simply cannot be wrong. 85% of people log onto their Facebook account every single day.

Any news media presently in business already has built or is building a social media presence. Twitter, Facebook and Google + seem to be in the lead of popularity and each has it’s own model which changes almost daily in an effort to capture the most users.

Recently I have been in several hangouts on Google + where people have asked for my medical opinion in the hangout. Each of them has expressed their willingness to “waive their privacy rights'” under current HIPAA laws.

Physicians are entrenched in patient privacy and confidentiality by their own training and ethics long before HIPAA was passed. Despite this restriction, many patients already waive privacy when they allow their story to be told at grand rounds in presentations, for testimonials regarding treatments, in other media and for other purposes. Does this carry forward for social media?

I would like to ask the readership their opinions and experience in this matter? How many of you have been asked this same question, and what have you advised? Would a verbal waiver be adequate or would you require it to be in writing?

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What most physicians recognize is that access to a physician (and almost any physician) is restricted by time and distance. Patient abhor our new systems of telephone trees and triage. Numerous times potential patients express their desire to interact on social media or email with their physician even preferring to leave a ‘message’ via email, twitter or Google plus.

With the enormous increase in ‘Boomers’ our system is about to be stressed beyond it’s limits unless some creative steps are taken by universal acclaim. We cannot wait for governments to solve problems that physicians and patients are able to address together. The perfect storm of limiting reimbursements, and increasing benefits, and access threaten our health system. The first step has already taken place by eliminating pre-existing conditions, and extending eligibility of children under the age of 25 under their parent’s policies.

Physicians should start thinking about setting aside fifteen to thirty minutes a day to devote to patient care via social media. Some are already doing this via secure email or built in secure messaging in their electronic medical record systems. However not all EMRs are created equal and most do not afford this feature.

Most patients no longer find a physician through the yellow pages..they search on Google. Google also indexes social media, and blogs. Their entrance to your practice (other than an insurance roster) is already via a search engine, be it BING, YAHOO, or GOOGLE, Twitter and Facebook. Patients can even invite you to a Google Plus Hangout. And these can be one on one.

Internet social media is only beginning and will be adapted in ways we cannot yet even imagine. It has already become a commonplace feature of broadcast television, anchor news, and international links between non major news sources for direct news bypassing conventional syndicated news sources such as CNN, FOX, ABC and NBC. It may become a primary source for professional journal news releases.

Disclaimer

The opinions in this blog or other forms of social media are solely that of Gary M. Levin M.D. Dr. Levin has no financial interests in any medical devices which are discussed or which appear in the blog. Commentary taken from other sources are either quoted or referenced with attribution. Dr Levin does not endorse, nor give financial support to any political organizations.